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Operative Trends in Orthopaedic Hand Surgery Fellowships.

James J Drinane1, Stella Lee2, Yannick A J Hoftiezer2

  • 1Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, New York, United States.

Journal of Hand and Microsurgery
|September 13, 2023
PubMed
Summary

Hand surgery fellowship operative experience has significantly increased over the past decade. Fellows now perform more procedures, particularly in nerve, fracture, and soft tissue categories, indicating a robust training environment.

Keywords:
fellow educationfellowshipgraduate medical educationhand surgeryorthopaedic

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Area of Science:

  • Orthopaedic Surgery
  • Hand Surgery Fellowship Training
  • Medical Education Research

Background:

  • Over 50 hand surgery fellowship programs exist in the US.
  • Evolving healthcare and education necessitate fellowship program evaluation.
  • Trends in surgical training require updated analysis.

Purpose of the Study:

  • To identify trends in operative experience for hand surgery fellows.
  • Analyze changes in procedure volume, surgery type, and anatomic region over time.
  • Evaluate the impact of healthcare and educational changes on fellowship training.

Main Methods:

  • Utilized National Accreditation Council for Graduate Medical Education (ACGME) case logs.
  • Included data from graduating orthopaedic hand surgery fellows (2011-2019).
  • Applied Mann-Kendall test to trend procedure categories over time.

Main Results:

  • Mean annual procedures per fellow increased from 797.6 (2011) to 945.6 (2019).
  • Significant increases observed in soft tissue, fracture, and nerve procedures.
  • Decreases noted in congenital procedures; increases in amputation and Dupuytren's procedures.

Conclusions:

  • Orthopaedic hand surgery fellowship operative experience has grown over the last decade.
  • Increased volume driven by nerve, fracture, and soft tissue procedures.
  • Fellowship training remains robust, with expanding operative exposure.